Stay away from first generation cephalosporins, but second and third generation agents appear safer than commonly believed. In a systematic review of PCN allergic patients receiving cephalosporins (originally published in J Fam Pract and abstracted as POEM in CCJM) rash occurred in 2% but anaphylaxis was rare (0.1%-0.0001%). Patients with a history of type I hypersensitivity to PCN should avoid first generation cephalosporins but may be able to safely take second or third generation cephalosporins.
Background: Coombs and Gell classification of hypersensitivity.
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